Deck 41: Alterations of Musculoskeletal Function in Children

Question 1

The onset of Duchenne muscular dystrophy usually occurs at approximately 3 years of age.

Answer 1

True

Question 2

Which disorder is characterized by failure of bones to ossify resulting in soft bones and skeletal deformity?

A) Osteogenesis imperfecta
B) Rickets
C) Osteochondrosis
D) Perthes disease

Answer 2

Rickets

Question 3

Poor posture results in structural scoliosis.

Answer 3

False

Question 4

The appendicular skeleton grows faster than the axial skeleton during childhood.

Question 5

The total mass of muscle in the body can be estimated from which serum laboratory test value?

A) Albumin
B) Blood urea nitrogen
C) Creatinine
D) Creatine

Question 6

The _____ is cartilage that retains the ability to form and calcify new cartilage and deposit bone until the skeleton matures.

A) epiphyseal line
B) physeal plate
C) epiphyseal cartilage
D) metaphyseal plate

Question 7

The most common skeletal defect of the upper extremity is:

A) vestigial tabs.
B) Paget disease.
C) rickets.
D) syndactyly.

Question 8

The normal lordotic curve of the lower spine begins to develop when the infant begins sitting.

Question 9

Staphylococcus aureus may cause osteomyelitis in newborns and older children.

Question 10

What diagnosis is given when the infant's hip maintains contact with the acetabulum,but is not well seated within the hip joint?

A) Dislocatable hip
B) Subluxated hip
C) Dislocated hip
D) Subluxable hip

Question 11

The major errors in osteogenesis imperfecta lie in the synthesis of:

A) collagen.
B) cartilage.
C) osteoblasts.
D) bone cell precursors.

Question 12

An insufficient dietary intake of which vitamin can lead to rickets in children?

A) Vitamin C
B) Vitamin B₁₂
C) Vitamin B₆
D) Vitamin D

Question 13

Growth from epiphyseal lines takes place at the same rate at both ends of the bones because they are under hormonal control.

Question 14

Limb girdle muscular dystrophy is considered when acute causes of proximal weakness are eliminated and the clinical findings and inheritance pattern eliminate Duchenne and facioscapulohumeral muscular dystrophy.

Question 15

Which serum laboratory test is elevated in all forms of osteogenesis imperfecta?

A) Phosphorous
B) Calcium
C) Alkaline phosphatase
D) Total protein

Question 16

In both adult and juvenile rheumatoid arthritis,the large joints are predominately affected.

Question 17

Which of the following is a very late sign or symptom of developmental dysplasia of the hip?

A) Asymmetry of the gluteal or thigh folds
B) Leg length discrepancy
C) Waddling gait
D) Pain

Question 18

In osteomyelitis,infection may spread to adjacent joints in the leg because the epiphyseal plate of the proximal femur is located within the hip joint and the distal femur is partially located within the knee.

Question 19

Which skeletal deformity is normal at birth,but disappears by age 2.5 years?

A) Genu varum (bowleg)
B) Genu valgum (knock knee)
C) Equinovarus (clubfoot)
D) Pes planus (flat feet)

Question 20

Unlike adult-onset arthritis,juvenile rheumatoid arthritis is not a syndrome that is often accompanied by systemic manifestations.

Question 21

If a child inherits facioscapulohumeral muscular dystrophy,she most likely inherited it from her:

A) father.
B) mother.
C) affected parent.

Question 22

Which bones are affected in Legg-Calvé-Perthes disease?

A) Heads of the femur
B) Distal femurs
C) Heads of the humerus
D) Distal tibias

Question 23

What is a cause of osteochondroses?

A) Imbalance between calcitonin and parathyroid hormone
B) Nutritional deficiency of calcium and phosphorous
C) Bacterial infection of the bone
D) Vascular impairment and trauma to bone

Question 24

What is Osgood-Schlatter disease?

A) Lateral epicondylitis of the elbow
B) Inflammation of the anterior cruciate ligament
C) Bursitis of the subscapular bursa in the glenohumeral joint
D) Tendinitis of the anterior patellar tendon

Question 25

Osteosarcomas usually metastasize to the:

A) pancreas.
B) liver.
C) lungs.
D) brain.

Question 26

Which of the following muscular dystrophy syndromes develops from an X-linked recessive mode of inheritance?

A) Duchenne
B) Facioscapulohumeral
C) Myotonic
D) Limb girdle

Question 27

Which protein,present in normal muscle cells and absent in muscle cells of Duchenne muscular dystrophy,mediates the anchoring of skeletal muscles fibers to the basement membrane?

A) Syntrophin
B) Laminin
C) Dystrophin
D) Troponin

Question 28

MATCHING
Match the type of muscular dystrophy with its description.The types may be used more than once.
The face is expressionless and pouting of the lips makes whistling impossible

A)Duchenne muscular dystrophy
B)Facioscapulohumeral muscular dystrophy
C)Scapuloperoneal muscular dystrophy
D)Myotonic dystrophy
E)Becker muscular dystrophy

Question 29

Rhabdosarcoma can develop anywhere _____ muscle is located.

A) cardiac
B) smooth
C) involuntary
D) striated

Question 30

In osteomyelitis,bacteria gain access to the subperiosteal space in the metaphysis,which is considered the "path of least resistance." What factor makes this route for bacteria the path of least resistance?

A) Cortex of the bone in this area is porous or mazelike.
B) Blood supply to the metaphysis is easily compromised.
C) Macrophages and lymphocytes have limited access to the subperiosteal space.
D) Bacteria usually spread down the medullary cavity of the bone.

Question 31

From where does the Ewing sarcoma arise?

A) Bone marrow
B) Bone producing mesenchymal cells
C) Metadiaphysis of long bones
D) Embryonal osteocytes

Question 32

MATCHING
Match the type of muscular dystrophy with its description.The types may be used more than once.
Onset at approximately age 3 with rapid progression and frequent mental retardation

A)Duchenne muscular dystrophy
B)Facioscapulohumeral muscular dystrophy
C)Scapuloperoneal muscular dystrophy
D)Myotonic dystrophy
E)Becker muscular dystrophy

Question 33

In scoliosis,curves in the thoracic spine greater than _____ degrees result in decreased pulmonary function.

A) 40
B) 50
C) 60
D) 70

Question 34

How do children describe the pain experienced in Legg-Calvé-Perthes disease?

A) Pain is referred to elbows and upper and lower arms that is aggravated by activity and relieved by rest.
B) Pain is referred to knees,inner thighs,and groin and is described as a continuous ache and relieved by anti-inflammatory drugs.
C) Pain is referred to knees,inner thighs,and groin that is aggravated by activity and relieved by rest.
D) Pain is referred to the elbows and upper and lower arms and is described as a continuous ache and relieved by anti-inflammatory drugs.

Question 35

Molecular analysis has demonstrated which oncogene associated with osteosarcoma?

A) p53
B) src
C) myc
D) TSC2

Question 36

How are the clinical manifestations and onset of juvenile rheumatoid arthritis (JRA)different from rheumatoid arthritis (RA)in adults?

A) JRA begins insidiously with systemic signs of inflammation.
B) JRA predominantly affects large joints.
C) JRA has more severe joint pain than RA.
D) JRA has a rapid onset of generalized aches as the first symptom.

Question 37

Cerebral palsy is usually a result of:

A) brain ischemia during birth.
B) prematurity.
C) congenital defects.
D) genetic defect.

Question 38

The most common malignant bone tumor during childhood is:

A) chondrosarcomA.
B) fibrosarcoma.
C) Ewing sarcoma.
D) osteosarcoma.

Question 39

MATCHING
Match the type of muscular dystrophy with its description.The types may be used more than once.
Often called the benign Duchenne muscular dystrophy because it shares the inheritance link,but produces milder symptoms

A)Duchenne muscular dystrophy
B)Facioscapulohumeral muscular dystrophy
C)Scapuloperoneal muscular dystrophy
D)Myotonic dystrophy
E)Becker muscular dystrophy

Question 40

What contributes to the pulmonary complications in children with Duchenne muscular dystrophy?

A) Chronic heart failure
B) Kyphoscoliosis
C) Impaired formation of alveoli
D) Anemia

Question 41

MATCHING
Match the type of muscular dystrophy with its description.The types may be used more than once.
First symptoms are drooping of shoulders and difficulty raising arms above the head

A)Duchenne muscular dystrophy
B)Facioscapulohumeral muscular dystrophy
C)Scapuloperoneal muscular dystrophy
D)Myotonic dystrophy
E)Becker muscular dystrophy

Question 42

MATCHING
Match the type of muscular dystrophy with its description.The types may be used more than once.
If the affected individual marries and has children,all daughters will be carriers of this X-linked recessive disorder

A)Duchenne muscular dystrophy
B)Facioscapulohumeral muscular dystrophy
C)Scapuloperoneal muscular dystrophy
D)Myotonic dystrophy
E)Becker muscular dystrophy

Question 43

MATCHING
Match the type of muscular dystrophy with its description.The types may be used more than once.
Distal muscles of the lower extremities are involved causing foot drop

A)Duchenne muscular dystrophy
B)Facioscapulohumeral muscular dystrophy
C)Scapuloperoneal muscular dystrophy
D)Myotonic dystrophy
E)Becker muscular dystrophy

Question 44

MATCHING
Match the type of muscular dystrophy with its description.The types may be used more than once.
Muscle weakness always begins in the pelvic girdle causing a "waddling" gait

A)Duchenne muscular dystrophy
B)Facioscapulohumeral muscular dystrophy
C)Scapuloperoneal muscular dystrophy
D)Myotonic dystrophy
E)Becker muscular dystrophy

Question 45

MATCHING
Match the type of muscular dystrophy with its description.The types may be used more than once.
Autosomal dominant with a slow rate of progression and frequent mental retardation

A)Duchenne muscular dystrophy
B)Facioscapulohumeral muscular dystrophy
C)Scapuloperoneal muscular dystrophy
D)Myotonic dystrophy
E)Becker muscular dystrophy